Derbekyan V A, Pham C, Emond C, Novales Diaz J A, Lisbona R
Department of Nuclear Medicine, Royal Victoria Hospital, Montreal, Quebec, Canada.
Clin Nucl Med. 1999 Mar;24(3):161-3. doi: 10.1097/00003072-199903000-00004.
The authors describe an adult patient with low index of suspicion for polysplenia. The diagnostic contribution of various investigative modalities is considered, and the key role of scintigraphy is specifically highlighted.
CT scan findings revealed multiple abdominal and retroperitoneal masses. Needle biopsy of a flank mass was nonspecific. Tc-99m sulfur colloid liver spleen scintigraphy and Tc-99m heat-denatured RBC scans showed the presence of polysplenia.
Multiple spleens can be mistaken for abdominal neoplasms on CT. Biopsy results may not always be helpful. In patients in whom there is such a diagnostic dilemma, Tc-99m heat-denatured RBC scans can successfully establish the definitive diagnosis of polysplenia.
作者描述了一名对多脾症怀疑指数较低的成年患者。文中考虑了各种检查方式的诊断作用,并特别强调了闪烁扫描的关键作用。
CT扫描结果显示腹部和腹膜后有多个肿块。对一侧腰部肿块进行穿刺活检,结果不具特异性。锝-99m硫胶体肝脾闪烁扫描和锝-99m热变性红细胞扫描显示存在多脾症。
在CT上,多个脾脏可能被误诊为腹部肿瘤。活检结果不一定总能提供帮助。对于存在这种诊断困境的患者,锝-99m热变性红细胞扫描能够成功确诊多脾症。